Therapeutic and training device for the shoulder joint

ABSTRACT

The invention relates to a therapy and training device for the shoulder joint ( 43 ) with a trunk base ( 21 ), having a rotational joint base ( 22 ) two shoulder extensions ( 27 ), respectively associated with a shoulder, rotational around a vertical axis of a shoulder rotational joint means, having an arm extension, respectively spaced apart from the rotational joint base for connection with an arm ( 42, 48 ), which is rotationally connected with the shoulder extension ( 27 ) around a transverse axis ( 37 ) by an upper arm rotational joint means ( 30 ), wherein said shoulder extension and/or said arm extension are coupled in movement such that a rotational movement of one shoulder extension, or respectively, one arm extension, causes a rotational movement of the other shoulder extension, or respectively, the other arm extension.

FIELD OF THE INVENTION

The present invention relates to a therapy and training device for theshoulder joint with a trunk base having two shoulder extensions on arotational joint base, respectively associated with a shoulder,rotational around a vertical axis of a rotational shoulder joint means,having respectively spaced apart from the rotational joint base an armextension for connection with an arm, which is rotationally connectedwith the shoulder extension around a transverse axis by an upper armrotational joint means, wherein the shoulder extensions and/or the armextension are coupled together for movement such that a rotationalmovement of one shoulder extension, or respectively, of an arm extensioncauses a rotational movement of the other shoulder extension, orrespectively, of the other arm extension.

BACKGROUND OF THE INVENTION

Therapy and training devices utilized for the treatment of movementconstraints in an extremity and based on the principle that through themovement of the healthy extremity a movement of the extremity restrictedin its mobility is induced, have so far been used for therapy andmobility training of knee joint. Such a therapy and training device is,for example, known from DE 195 09 465 A1. The known therapy and trainingdevice serves to treat movement constraints on a knee joint and, due tothe substantially single-axis joint form of the knee joint, isrelatively simply equipped with only a rotational joint means whichconnects a lower leg receptacle and an upper leg receptacle as a joint,wherein in therapy operation ideally the rotational axis of therotational joint means corresponds with the knee joint axis of thepatient.

Whereas in practice there is a particularly great need forrehabilitation with regard to movement constraints on the knee joint dueto the frequency of knee injuries and associated knee operations,movement constraints on joints, however, generally are alwaysascertained when a prolonged immobilization of the joint was necessaryafter a surgical procedure. This also applies in particular withshoulder injuries or surgical procedures on the shoulder which can leadto considerable restrictions in movement in the shoulder region. Basedon the complexity of the joint situation in the shoulder area, it is notpossible, however, to use the known therapy and training device for acorresponding therapy of a shoulder joint.

SUMMARY OF THE INVENTION

From FR-A-1257 091 a therapy and training device for the shoulder jointis known, having a trunk base, which has on a rotational joint base twoshoulder extensions, respectively associated with a shoulder,rotationally coupled by means of a rotational joint means. The shoulderextensions, respectively spaced apart from the rotational joint base,are provided with an arm extension, which is rotationally connected withthe shoulder extension around a transverse axis by a upper armrotational joint means. The arm extensions are coupled in movement suchthat a rotational movement of an arm extension causes a rotationalmovement of the other arm extension.

From FR-A-2 789 304 a device is known for the passive mobilization ofthe upper limbs with different motor means for the prompting of movementdrive of a patient's arm.

U.S. Pat. No. 5,613,928 shows a training device with two arm handlescoupled in movement for muscle training.

From U.S. Pat. No. 4,971,040 a portable massage chair is known forperforming massage therapy in any location.

The object of the present invention is to propose a therapy and trainingdevice that enables the performance of a complex movement treatment forthe shoulder joint.

This object is achieved by therapy and training device exhibiting thefeatures of claim 1.

In the therapy and training device according to the invention, therotational joint means is formed as a rotational shoulder joint meanssuch that the shoulder extensions are rotational around a vertical axisof the rotational shoulder joint means and are coupled in movement suchthat a rotational movement of the one shoulder extension causes arotational movement of the other shoulder movement.

The configuration of the therapy and training device according to theinvention particularly takes into account the shoulder anatomy, leadingto the fact that shoulder movements, as a rule, induce arm or at leastupper arm movements and vice versa. For example, already a simpleforward and backward movement of a shoulder is combined with even aslight rotational movement of the upper arm. Such complexinterrelationships of movement require a corresponding jointconfiguration on the therapy and training device. For the forward andbackward movement, thus, the formation of a vertical axis on the therapyand training device is necessary which is arranged preferably adjacentto the shoulder base. In order to enable the overlapping rotationalmovement of the upper arm with the forward and backward movement, theformation of a rotating axis running correspondingly transverse to thevertical axis is required, which enables a so-called ante- andretro-version of the arm, therefore a forward and backward swinging.

The forward and backward movement of the shoulder blade with theoverlapping forward and backward movement of the arm is enabled by theshoulder extension, formed as a joint lever, enabling a connectionbetween the shoulder rotational joint means and the upper arm rotationaljoint means, thus, between the vertical axis and the transverse axis. Totransmit the rotational movement executed on one side of the body by theshoulder blade or the arm or both to the other side of the body, theshoulder extension respectively associated with the other side of thebody, or respectively, the arm extension associated with the other sideof the body is respectively coupled in movement with its correspondingcounterpart.

Particularly for the repositioning of the therapy and training devicerelative to the upper body of the patient, it is advantageous when apositioning means for the relative positioning vis-a-vis the spinalcolumn of the patient is associated with the rotational joint base.Through this, it is possible to position the therapy and training deviceto the upper body of the patient without requiring an adjustment of thejoint configuration of the therapy and training device to the individualanatomy of the patient even after an interruption of therapy and for theresumption of therapy.

A particularly direct manner of positioning results when the positioningmeans has a neck receptacle, adjustable in height, arranged on therotational joint base along the trunk base. The neck receptacle,furthermore, also provides a possibility to prevent voluntary orinvoluntary avoidance movements of the upper body during the operationof the therapy and training device which could negatively affect, inparticular, the desired adjustment of the joint configuration of the totherapy and training device to the individual anatomy of the patient. Inprinciple, of course, other correspondingly effective means can beprovided.

When the arm extension on the therapy and training device comprises anupper arm extension and a lower arm extension, wherein the upper armextension is connected to the shoulder extension via the upper armrotational joint means and the lower arm extension via an elbow jointmeans comprising at least a rotational axis is connected to the upperarm extension, it is possible to also integrate lower arm movements. Forthis purpose, relative movements in the simplest form of the lower armcompared to the upper area are sufficient, without having to transmitthe movements of the lower arm extension like the movements of the upperarm extension and of the shoulder extension on the other side of thebody in movement-coupled manner. Since relative movements of the lowerarm can often be performed without restrictions compared to the upperarm with a shoulder restricted in movement, a corresponding coupling ofthe movement of the lower arm extensions of both sides can be omitted.Since, on the other hand, however, changed relative positions of thelower arm compared to the upper arm due to the associated displacementof mass can very well affect movements of the shoulder, the relativemobility of the lower arm extension can positively affect the success oftherapy.

In addition, when the elbow joint means has two rotational axes, whereina vertical axis runs transverse to the longitudinal extension of theupper arm extension and a transverse axis runs in the direction of thelongitudinal extension of the upper arm extension, a coaxial joint meansis formed which substantially corresponds to the actual anatomicalproportions on the elbow joint.

Further, when the connection of the arm extension with an arm takesplace by means of a connecting means arranged on the lower armextension, e.g. longitudinal rotations of the upper arm compared to theupper arm extension are readily possible. For that reason, for example,it can be dispensed with forming the upper arm rotational joint meanssuch that also longitudinal rotations of the upper arm extension arepossible.

In a particularly advantageous embodiment of the therapy and trainingdevice at least one lower arm extension is provided with an actuatingmeans to trigger a locking device operative on the upper arm rotationaljoint means, wherein an actuation of the actuating means results whenthe associated lower arm is released from its connection with the lowerarm extension. Through this, a kind of “emergency switch” is realizedwhich prevents that movements are performed by the unsound shoulderwhich are not performed by the sound extremity of the opposite side, orrespectively, the sound shoulder, so that, for example, the unsound armafter a release of the connection of the lower arm of the sound sidewith the lower arm extension cannot fall down as a result of gravityfrom an elevated position.

A possible embodiment of such an “emergency switch” can, for example,consist of a control knob provided with a switch is provided at the freeend of the lower leg receptacle, in which the switch is actuated by arelease of the handle.

If the upper arm extension can be adjusted in its operative lengthbetween the upper arm rotational joint means and the elbow joint means,it is possible to compensate deviations between the rotational axis ofthe upper arm rotational joint means and the actual rotational axis ofthe shoulder joint by appropriate adjustments in length, without havingconstraints in movement arise.

A particularly effective therapy for the rehabilitation of movementrestrictions on an affected shoulder joint is possible, when for coupledmovement at least the shoulder rotational joint means and the upper armrotational joint means of a side of the body are coupled withrespectively the shoulder rotational joint means and the upper armrotational joint means of the other side of the body by means of acoupling means, such that a joint movement on one side of the bodycauses a defined joint movement of the corresponding joint means on theother side of the body. According to the form of the correspondingcoupling means, the induced counter movement takes place conversely,inversely or also in a defined geared transmission or reduction ratio.

In order to be able to prevent, for example, undesired or even harmfulmovements, the joint means provided on the therapy and training devicecan be provided at least partially with means to restrict jointmovements.

In a further possible embodiment, the coupling means for coupledmovement of the shoulder rotational joint means is formed as a wheelgear, wherein the wheel gear can be formed as a friction gear or as agearwheel.

In a further preferable embodiment, the coupling means for the coupledmovement of the upper arm rotational joint means is formed as a tractionmechanism or a pressure gear so that a transfer of force can ensue bycable or by hydraulic fluid.

A preferable modular form of the therapy and training device enabling aneasy adjustment to the given proportions is given if the trunk base hasa connecting means for connection with a seat frame or a seat ingeneral.

The trunk base can also be provided with a seat so that a use of thetherapy and training device is possible independent from any furtherlocal requirements.

It is particularly advantageous when the seat frame is arranged to openout on the trunk base.

The various features of novelty which characterize the invention arepointed out with particularity in the claims annexed to and forming apart of this disclosure. For a better understanding of the invention,its operating advantages and specific objects attained by its uses,reference is made to the accompanying drawings and descriptive matter inwhich a preferred embodiment of the invention is illustrated.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings:

FIG. 1 is a perspective view of an embodiment of a therapy and trainingdevice for the shoulder joint in neutral position with seat frame readyfor use.

FIG. 2 shows the therapy and training device according to FIG. 1 withfolded seat frame.

FIG. 3 shows the therapy and training device with an extended upper armextension in contrast to the illustration in FIG. 1.

FIG. 4 shows the therapy and training device with upper arm extensionrotated downwards around the transverse axis.

FIG. 5 shows the therapy and training device with upper arm extensionrotated upwards around the transverse axis.

FIG. 6 shows in plan view the therapy and training device in neutralposition.

FIG. 7 shows the therapy and training device with shoulder extension 5rotated inward around a vertical axis.

FIG. 8 shows the therapy and training device with shoulder extensionrotated outward around a vertical axis.

FIG. 9 shows the therapy and training device with lower arm extensionrotated upward around a transverse axis.

FIG. 10 shows the therapy and training device with lower arm extensionrotated downward around a transverse axis.

FIG. 11 shows the therapy and training device with lower arm extensionrotated outward around a vertical axis.

FIG. 12 is a schematic illustration of a first coupling means forcoupled movement of both shoulder extensions and a second coupling meansfor coupled movement of both upper arm extensions of the therapy andtraining device.

DESCRIPTION OF THE PREFERRED EMBODIMENT

Referring to the drawings in particular FIG. 1 shows a therapy andtraining device 20, which hereinafter will be shortened to therapydevice, with a trunk base 21, a rotational joint base 22 arranged on thetrunk base 21 and a seat frame 23 also arranged on the trunk base.

The rotational joint base 22 serves to couple a shoulder/arm jointsystem 24, comprising two shoulder/arm joint units 25, 26 formedsymmetrically to the rotational joint base 22, or respectively, to thetrunk base 21, of which in the following only the right shoulder/armjoint unit 25 is illustrated in detail. The shoulder/arm joint unit 25comprises as in the shoulder/arm joint unit 26 not illustrated indetail, a shoulder extension 27, rotational around a vertical axis 28 bymeans of a rotational shoulder joint means 29 coupled to the rotationaljoint base 22. The shoulder extension 27 formed in the present casecranked downward is provided with an upper arm rotational joint means 30on its distal end, such that an arm extension 32 is coupled on theshoulder extension 27 to be rotational around a transverse axis 31.

The arm extension 32 has an upper arm extension 33 directly connectedwith the upper arm rotational joint means 30 and a lower arm extension35, attached by an articulated elbow joint means 34. The elbow jointmeans 34 enables a relative swinging of the lower arm extension 35compared to the upper arm extension 33 around a vertical axis 36 and atransverse axis 37 running substantially in the direction of thelongitudinal extension of the upper arm extension 33.

As can be seen clearly from a joint viewing of FIGS. 1 and 2, the seatframe 23 is attached by a hinge joint 38 to the trunk base 21 as afolding frame with a seat board 39 that can be folded up against thetrunk base 21 and with a supporting leg 41 connected to the seat board39 by a hinge joint not shown in detail.

To illustrate the proportions and a relative arrangement of theindividual parts forming the shoulder/arm joint system 24, orrespectively, the shoulder/arm joint unit 25, a human figure in seatedposition is shown schematically in FIG. 3 with extremities on theright-hand side indicated, wherein a lower arm 42 is situated in aposition connected with the lower arm extension 35, the right shoulder43 is situated below the shoulder extension 27 and an upper arm 48extends on the inner side of the upper arm extension 33 from the upperarm rotational joint means 30 to the elbow joint means 34.

FIG. 3 further illustrates that a relative positioning of the human bodyto the therapy and training device 20 occurs via a positioning meansformed as a neck receptacle 44 in the present case, which is an integralpart of the rotational joint base 22. The force transmission for thetransmission of movement from the shoulder/arm region on the therapy andtraining device, or respectively, the shoulder/arm joint system 24 andvice verse occurs via the connection of the lower arm 42 with the lowerarm extension 35 by means of a connecting means 45. Moreover, acomparison of FIGS. 3 and 1 illustrates clearly that an adjustment ofthe shoulder/arm joint system 24, or respectively, the shoulder/armjoint unit 25 to the upper body extremities can ensue by a change of theeffective length L of the upper arm extension 33, which consists forthis purpose of two parts adjustable in the longitudinal directionrelative to each other, namely an upper part 46 and a lower part 47. Anadjustment of the length of the shoulder extension 27 to the individualbody proportions is generally not necessary, but can of course also beprovided.

Starting from the configuration illustrated in FIGS. 1 and 3 definedhere as the neutral position of the shoulder/arm joint unit 25, thetherapy device 20 in the present embodiment form enables the relativepositions or movements illustrated in the following FIGS. 4 to 11.

FIGS. 4 and 5 illustrate the possibility of performing with the lowerarm 42 (FIG. 3) connected with the lower arm extension 35 by theconnecting means 45 (FIG. 3) a forward and backward movement of theentire arm with the lower arm 42 (FIG. 3) bent relative to the upper arm48. In this configuration, in order to set a defined angle of the crookof the arm, the lower arm extension 35 can be fixed opposite the upperarm extension 33 by tightening the elbow joint means 34. The upper armjoint rotational means 30 enables a rotating around the transverse axis31. This forward and backward movement of the upper arm. 48 effects acorresponding movement of a shoulder blade 49.

FIG. 12 shows a coupling means 50, which enables a transmission of theforward and backward movement carried out with the right extremity, thushere with the upper arm 48, by means of the shoulder/arm joint system 24on the left upper body extremity not shown in FIG. 3, thereby alsoenabling an induction of movement in the left shoulder. Hereunto thecoupling means 50 acts between the upper arm extension 33 of the rightshoulder/arm joint unit 25 illustrated in FIG. 3 and an upper armextension 51 of the left shoulder/arm joint unit 26 associated with theleft upper body extremity. As shown in FIG. 12, the coupling means 50comprises two force transmission means executed as reversing cablesystems 52, 53. The reversing cable system 52 acts between two cablerolls 54, 55, which are arranged non-rotational on the transverse axis31 of the upper arm rotational joint means 30 with the upper armextension 33 or rotational on trunk base 21. The cable roll 55 is formedas a dual cable roll and is via the reversing cable system 53 infriction-locked engagement with a further cable roll 56, which analogousto the cable roll 54 on the transverse axis 31 of the upper armrotational joint means 40 of the left shoulder/arm joint unit 26 isnon-rotationally engaged with an upper arm extension 57. By means of thecoupling means 50, thus, an ensuing rotational movement of the upper armextension 33 is transmitted in the direction of an arrow 58 via thereversing cable system 52 onto the cable roll 55 and from the cable roll55 via the reversing cable system 53 onto the cable roll 56,non-rotationally engaged with the upper arm extension 57. In the presentcase, thus, through a rotational movement of the right upper arm aconverse rotational movement of the left upper arm is induced. Theinduction of a converse rotational movement is simply possible, forexample, by means of a crossed cable arrangement of one of the tworeversing cable systems 52, 53.

In FIGS. 6 to 8, a forward and backward movement of the shoulderextension 27 is illustrated with the fixed lower arm extension 35 in itsbent position relative to the upper arm extension arm 33. Here arotation of the shoulder extension 27 takes place around the verticalaxis 28 of the shoulder rotational joint means 29. For the transmissionof this rotational movement starting from the right shoulder/arm jointunit 25 to the left shoulder/arm joint unit 26 (FIG. 1) not shown indetail in FIGS. 6 to 8, a coupling means 59 illustrated in FIG. 12 canbe used. For the transmission of the rotational movement of the rightshoulder extension to 27, which is rotationally coupled in the shoulderrotational joint means 29 around the vertical axis 28 on the rotationaljoint base 22, a bearing end 60 of the shoulder extension 27 is providedwith a gearwheel segment 61 which is in engagement with a furthergearwheel segment 62 which is formed on a bearing end 63 of a shoulderextension 64 of the left shoulder/arm joint 26. Analogous to the bearingend 60, the bearing end 63 of the shoulder extension 64 is supported ina shoulder rotational joint means 65 of the rotational joint base 22.

The coupling means 59 enables thus the transmission of a rotationalmovement 66 from the right shoulder extension 27 to the left shoulderextension 64 so that starting from a movement of the right shoulder viathe coupling means 59, a corresponding rotational movement 67 of theleft shoulder can be induced.

FIGS. 9 and 10 illustrate the rotatability of the lower arm extension 35around the transverse axis 37 of the elbow joint means 34. Thisrotational movement can be transmitted by means of a coupling means notshown in detail here from the right shoulder/arm joint unit 25 to theleft shoulder/area joint unit 26 not illustrated in FIG. 9. Already amovement-decoupled rotatability of the lower arm extension 35 of theshoulder/arm units 25, 26 affords advantages in the operation of thetherapy device 20 since the rotatability of the lower arm extension 35around the transverse axis 37 of the elbow joint means 34 as well as arotatability of the lower arm extension around the vertical axis 36(FIG. 11) of the elbow joint means 34 enables the patient to freelychose a comfortable relative position of the lower arms compared to theupper arms.

While specific embodiments of the invention have been shown anddescribed in detail to illustrate the application of the principles ofthe invention, it will be understood that the invention may be embodiedotherwise without departing from such principles.

What is claimed is:
 1. A therapy and training device for the shoulderjoint with a trunk body comprising on a rotational joint base twoshoulder extensions respectively associated with a shoulder, coupledrotationally by means of a shoulder rotational joint means, respectivelyhaving an arm extension spaced apart from the rotational joint base forconnection with an arm, which is rotationally connected with theshoulder extension around a transverse axis by an upper arm rotationaljoint means, wherein the arm extensions are coupled in movement suchthat a rotational movement of one arm extension causes a rotationalmovement of the other arm extension, wherein the rotational joint meansis formed as a rotational shoulder joint means such that the shoulderextensions are rotational around a vertical axis of the rotationalshoulder joint means and coupled in movement such that a rotationalmovement of one shoulder extension causes a rotational movement of theother shoulder extension.
 2. The therapy and training device accordingto claim 1, wherein the rotational joint base has a positioning meansassociated thereto for the relative positioning vis-a-vis the spinalcolumn of a patient.
 3. The therapy and training device according toclaim 2, wherein the positioning means has a neck receptacle along thetrunk base adjustable in height and arranged on the rotational jointbase.
 4. The therapy and training device according to claim 1, whereinthe arm extension comprises an upper arm extension and a lower armextension, wherein the upper arm extension is connected with theshoulder extension by the upper arm rotational joint means, and thelower arm extension is connected with the upper arm extension by anelbow joint means comprising at least one rotational axis.
 5. Thetherapy and training device according to claim 4, wherein the elbowjoint means has two rotational axes, wherein a vertical axis runstransverse to the longitudinal extension of the upper arm extension anda transverse axis in the direction of the longitudinal extension of theupper arm extension.
 6. The therapy and training device according toclaim 4, wherein a connection means is provided on the lower armextension for connection of the arm extension with an arm.
 7. Thetherapy and training device according to claim 4, wherein at least onelower arm extension is provided with an actuating means to trigger alocking means operative on the upper arm rotational joint means, whereinan actuation of the actuating means ensues when the associated lower armis released from its connection with the lower arm extension.
 8. Thetherapy and training device according to claim 4, wherein the upper armextension is adjustable in its effective length between the upper armrotational joint means and the elbow joint means.
 9. The therapy andtraining device according to claim 1, wherein for the coupling ofmovement at least the shoulder rotational joint means and the upper armrotational joint means of one side of the body are coupled withrespectively the shoulder rotational joint means and the upper armrotational joint means of the other side of the body by means of acoupling means such that a joint movement of one side of the bodyeffects a defined joint movement of the corresponding joint means on theother side of the body.
 10. The therapy and training device according toclaim 9, wherein the coupling means for a coupling movement of theshoulder rotational joint means is formed as a wheel gear.
 11. Thetherapy and training device according to claim 9, wherein the couplingmeans for the coupling movement of the upper arm rotational joint meansis formed as a traction mechanism or pressurizing gear.
 12. The therapyand training device according to claim 1, wherein the base body has aconnecting means for connection with a seat frame.
 13. The therapy andtraining device according to claim 1, wherein the trunk body is providedwith a seat frame.
 14. The therapy and training device according toclaim 13, wherein the seat frame is arranged to be folded down on thetrunk body.
 15. A therapy and training device comprising: a trunk bodywith a rotational joint base; two shoulder extensions coupledrotationally by a shoulder rotational joint means; arm extensions onsaid shoulder extensions spaced apart from said rotational joint base;and an upper arm rotational joint means, said arm extensions beingconnected with said shoulder extensions around a transverse axis by saidupper arm rotational joint means, said arm extensions being coupled inmovement such that a rotational movement of one said arm extensioncauses a corresponding rotational movement of the other said armextension, and wherein said rotational joint means is formed as arotational shoulder joint such that said shoulder extensions arerotational about a vertical axis of said rotational shoulder joint andcoupled in movement such that a rotational movement of one said shoulderextension causes a corresponding rotational movement of the other saidshoulder extension.
 16. A therapy and training device comprising: atrunk body, two shoulder extensions mounted to said trunk body by linkedshoulder joints, wherein a movement in one said shoulder extensioncauses a corresponding movement in the other said shoulder extensionthrough said linking of said shoulder joints; two upper arm extensionsmounted to said shoulder extensions by linked upper arm joints, whereina movement in one said upper arm extension causes a correspondingmovement in the other said upper arm extension through said linking ofsaid upper arm joints; and two lower arm extensions mounted to saidupper arm extensions by linked lower arm joints, wherein a movement inone said lower arm extension causes a corresponding movement in theother said lower arm extension through said linking of said lower armjoints.
 17. A therapy and training device according to claim 15 wherein,said trunk body has a positioning means for positioning the therapy andtraining device relative to the spinal column of a patient.
 18. Atherapy and training device according to claim 16 wherein, said trunkbody has a positioning means for positioning the therapy and trainingdevice relative to the spinal column of a patient.
 19. A therapy andtraining device according to claim 15 wherein, said trunk body has aneck receptacle adjustable relative to said trunk body.
 20. A therapyand training device according to claim 16 wherein, said trunk body has aneck receptacle adjustable relative to said trunk body.
 21. A therapyand training device according to claim 15 further comprising: armconnections for connection of said arm extensions to arms of a patient.22. A therapy and training device according to claim 16 furthercomprising: lower arm connections for connection of said lower armextensions to lower arms of a patient.
 23. A therapy and training deviceaccording to claim 16 further comprising: a seat on said trunk body.